The natural history and clinical significance of much of the observed depressive symptomatology in older individuals remains unclear. there is considerable evidence that, in older individuals, major depression (and other DSMIIIR diagnosed disorders such as dysthymia) occurs with limited frequency, e.g. between 1 and 2 per 100. In contrast less severe, subsyndromal, forms of depressive symptomatology that does not meet formal diagnostic criteria for major depression or dysthymia, occurs in a substantially larger proportion of older individuals. There is increasing evidence, as well, that the subsyndromal depressions are associated with significant morbidity. If it could be clearly established that the such depressions are associated with medical deterioration, functional disability, or increased medical care costs, it would suggest the potential value of significant modifications in medical care and mental health services. This study is designed to investigate the impact of clinically diagnosed depression and elevated depressive symptomatology not meeting DSMIIIR diagnostic criteria on the process of decline with respect to health status, functional performance and nutritional status and on the occurrence of health events and health service use. A 24 month, longitudinal, observational study of the natural history of depressive symptomatology and of the costs of depressive symptomatology in terms of excess disability and/or health system costs, is proposed. Approximately 100 residents of the independent and nursing care sections of the PGRC affiliated Continuing Care Retirement Communities (CCRC) who have elevated depressive symptomatology (Geriatric Depression Scale scores greater than 10) during a screening interview will be recruited into the study; 100 individuals without depressive symptoms will also be enrolled. In person interviews will be conducted at baseline and 6, 12, 18, and 24 months later. Assessment of physical performance using both self report and timed performance measures will be made at these times as well. Diagnosis of DSMIIIR syndromes, major depression and dysthymia, will be determined during baseline 6 and 12 month assessments using relevant portions of the Structured Clinical Instrument for DSMIIIR (SCID). Health care and cost data will be obtained for the 12 months preceding the baseline interview and for each 6 month interval thereafter.